AHRQ’s Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention
Three implementation documents are used to help the nursing home change team integrate the pressure ulcer prevention reports they choose to use into day-to-day clinical decisionmaking. They are:
- Self-Assessment Worksheet for Pressure Ulcer Prevention:
- Pressure Ulcer Prevention Menu of Implementation Strategies.
- Implementation Steps and Timeline.
This self- assessment worksheet is designed to help nursing home staff review how they screen for pressure ulcer risk, prevent pressure ulcers from occurring, prioritize residents who may need changes in care plans, discuss the care changes that are needed, and investigate root causes when a pressure ulcer develops.
There are four sections: screening for pressure ulcer risk, pressure ulcer risk prevention program, communication practices, and investigations/root cause analysis of pressure ulcer development.
Users and Uses
The main user is the pressure ulcer change team. The worksheet is designed so that the team answers a series of questions that guide them through an assessment of how they currently prevent pressure ulcers. Once they fill out the self-assessment and discuss it as a team, they need to summarize the gaps in current practices and think about ways the reports can help fill in the gaps. Not only is the On-Time Program attempting to improve risk identification and communication of risk with these reports, but it is also trying to make clinical decisionmaking a multidisciplinary activity if it is not already. The On-Time facilitator will help guide the change team through this process.